ASC Primary 2023
OFFICIAL
Malawi Government
MINISTRY OF EDUCATION
PRIVATE BAG 328 CAPITAL CITY LILONGWE 3
TEL.: +265 1 789 422 FAX: +265 1 788 064/164
FORM A: STATISTICAL RETURNS FOR PRIMARY SCHOOLS
YEAR: 2022/23
INSTRUCTIONS:
(1) This questionnaire should be completed by all Public and Private schools.
(2) Provide all information reflecting the condition in your school as of first week of December 2022 unless otherwise
indicated. The information collected will contribute to the Ministry’s Education Management Information System (EMIS)
and will assist in the management, administration, supply of school resources and governing of schools. If you have
questions, please consult your PEA, CPEA, Planner, DEM or EMIS headquarters.
(3) Please reply to all questions (do not leave any part blank or unanswered)
(4) Complete the form and submit to your DEMs Office.
(5) Information submitted will be handled with strict confidentiality
NOTICE: GIVING INACCURATE OR INCOMPLETE INFORMATION DELIBERATELY MAY LEAD TO DISCIPLINARY ACTION.
SECTION A: SCHOOL IDENTIFICATION
[ SCHOOL EMIS NUMBER]
Identifier
Name
Numeric Code
(Office use only)
A.1.School
A.2. Zone
A.3. District
A.4. Division
A.5. Traditional Authority
A.6. Constituency
If the information on the label is incorrect, please cross out the incorrect information and make the corrections. If an identifier is listed on the
label as an unknown, please fill in the correct name
A.7. Postal Address
A.8. Telephone/Cell
A.9. Email Address
QUESTIONNAIRE TRACKING INFORMATION/CERTIFICATION
(Fill in this information AFTER completing the appropriate action)
Official
Name
Signature
Date
DD/MM/YYYY
Head Teacher or Person completing the Questionnaire
ZEMIS Officer…….
District EMIS Officer (Questionnaire Reception and
Verification)
ASC Primary 2023
OFFICIAL
SECTION B: SCHOOL PARTICULARS
B.1. Proprietor
B.2. Type of Institution
B.3. School Shift
1. Public
2. Religious Institution (Specify Owner)
_______________________________________
3. Private (Specify Owner)
________________________________________________
1. Co-educational
(Mixed)
2. Boys only
3. Girls only
1. Single
2. Double
3. Overlapping
Which Classes
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
B.4. Time when school day classes
Begin (hh/mm)
End (hh/mm)
________/_______AM
_______/________PM
B.5. Distance to nearest
public primary school
B.6. Distance to the
TDC
B.7. Distance to the
DEM’s office
B.8 (a). Number of
supervisory visits by the
PEA previous year
B.8 (b). Number of inspection visits
previous year
Term 1
Term 2
Term 3
Term 1
Term 2
Term 3
Actual Distance
___________ km
Actual Distance
___________ km
Actual Distance
___________ km
1. One
2. Two
3. Three
4. More than three
5. None
1. One
2. Two
3. Three
4. More than three
5. None
B.9
Urban / Rural
(tick one)
B.10 Year
Establishe
d
(YYYY)
B.11. Is the school accessible by
road during the rainy season? (tick
one)
B.12. What material is the
roadway made of? (tick
one)
B.13. Who gave the authority for the
land to be used for the school? (tick
one)
1. Urban
2. Semi Urban
3. Rural
Remote
Most
Remote
_ _ _ _
Yes
No
Tar
Gravel
Earth
Village Headman
TA
Government
Other (Specify Name)
___________________
B.13.b. Is the school land leased?
Yes
No
B.14 Villages / locations where most pupils live (Please tick one for each village or location)
#
Name of Villages (with majority
pupils)
Many
Some
Few
Estimated Distance (KM)
1
2
3
4
5
6
7
B.15.a.1. Does the school get an external Assistance?
Yes
No (If no, go to B.15.b)
B.15.a 2. If yes, which are the NGOs/Donors? (Should describe whether active or inactive)
Description
Active
Inactive
Name of NGO/Donor
NGO 1
NGO 2
NGO 3
Donor 1
Donor 2
Donor 3
ASC Primary 2023
OFFICIAL
B.15.b. Community Participation
Description
Active
Inactive
None
If Active, how often they meet?
(1- Monthly, 2- Quarterly, 3- Once a year)
Community Volunteer
PTA
School Management Committee
Mother Groups
B.16. If Active, indicate what functions are provided by members ----
Description
PTA
School Management Committee
Community Volunteer
NGOs
Donor
Construction Labor
Prepare Food
School Management
Raise Funds
Support Teaching
Others
SECTION C: PUPIL INFORMATION
C.1. Enrolment by standard, sex and age (Provide data as of October this year)
Age
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
Total
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
<5
5
6
7
8
9
10
11
12
13
14
15
16
17
>17
Total
ASC Primary 2023
OFFICIAL
C.2.a. New entrants to Standard 1 by age and sex (DO NOT include repeaters)
Year/Sex
5 Years or
Less
6 Years
7 Years
8 Years
9 Years
10
Years
11 Years
12 Years
or More
TOTAL
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
New
Entrants
C.2.b. Number of New Entrants with Early Childhood Development Background/ passing through Early Childhood Development
(ECD)
Year/ sex
5 Years or
Less
6 Years
7 Years
8 Years
9 Years
10 Years
11
Years
12 Years
or More
TOTAL
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
ECD
Learners
C.3. Repeaters by Standard and sex (Pupil in the same grade for more than one school academic year)
Standards/Sex
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
Total
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Repeaters
C.4. (a)Number of Dropouts :(pupils who left before academic year completed) by Standard and sex (Previous year)
(Do not include known transfers)
Dropouts
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
Total
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Family
responsibilities
Pregnancy
Marriage
Fees (unable to pay)
Employment
Sickness
Poor Facilities
Truancy
Availability of
Teachers
Long distances
Natural Disasters
Poverty
Violence
Disability
Other (Specify)
1. _____________
2. _____________
Total
C.5. Number of Learners Readmitted to school (these are leaners who once dropped out and are now back to school)
Standard
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
Total
Sex
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Number
ASC Primary 2023
OFFICIAL
C.6. Orphans by Standard and sex
Standard/Sex
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
Total
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Single Parent died
Both Parents died
Total
C.7. Vulnerable by Standard and sex
Standard/Sex
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
Total
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Vulnerable Learners
C.8.Pupils with special learning needs by Standard and sex
(If a child has more than one special learning need, select the main one.)
Description
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
Total
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Low Vision
Blind
Hard of Hearing
Deaf
Physical Impairment
Deaf Blind
Pupils with learning
difficulties
Albinism
Total
NOTE: The following questions on pupils refer to PREVIOUS SCHOOL YEAR.
C.9. Number of pupils transferred into and out of your school by standard and sex (Previous school year)
(Include only known transfers and do not include dropouts)
Standard/Sex
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
Total
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Transfers In
Transfers Out
C.10. (b) Number of pupils who died / dismissed in the previous school year
Sex
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
Total
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Died
ASC Primary 2023
OFFICIAL
Dismissed
C.11. Primary School Leaving Examination results (Previous school year)
Detail/Sex
Entered
Sat
Passed
Failed
Selected
National
SS
District
SS
DAY
SS
CDSS
Total
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Examination
Result
C.12. Zonal Standardized tests
Detail/Sex
Entered
Sat
Passed
Failed
M
F
M
F
M
F
M
F
Standard 1
Standard 2
Standard 3
Standard 4
C.12. Zonal test report cards
Has the school received a
Report Card showing the
results of the Common Zonal
Testing?
Yes= 1
No = 2
Is the Report Card on display
in the head teacher’s office?
Yes = 1
No = 2
Is the Report Card on display
elsewhere in the school?
Yes = 1
No= 2
If Yes where is it displayed?
Inside another
office, building or
classroom
On an outside wall
of a building or
classroom
Elsewhere (specify)
C.13. Streams by Standard (i.e. Std. 1A, Std. 1B etc.)
Standards
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
Total
Number of streams
C.14.a Number of open-air classes
Standards
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
Total
Number of streams
ASC Primary 2023
OFFICIAL
C.15. ACCOUNTABILITY AND TRASPARENCY –
C.15
C.15.a. Did the stake holders
undergo Primary School
Improvement Program (PSIP)
refresher training in the previous
academic year
1 =Yes |___|
2 = No |___|
C. 15.b. Does the school
have a School Improvement
Plan (SIP)?
1= Yes |___|
2 = No |___|
C.15.c. Did the school
receive School
Improvement Grant (SIG)
in the previous Financial
Year (Ending March30th)?
1 = Yes |___|
2 = No |___|
C.10.c_1
If Yes, on what date(s) did
you receive …../……./
…../……./
C.15.d. How much SIG did the
school receive in the previous
Financial Year (Ending March
30th)?
MK:____________________
C.15.f. Did the school receive School Improvement Grant
(SIG) in the current Financial Year (Beginning 1st April)?
1 = Yes |___|
2 = No |___|
C.10c_1
If Yes, on what date did you receive …../……./
C.16.g. How much SIG did the school receive in the
Current Financial Year (Beginning 1st April)?
MK:____________________
C.11 Please state how much of the SIG was used for the following areas in the previous academic year:
(i) Improving promotion and
retention rates
(MK________________)
a. Reduction of class size
and overcrowding (hiring
of auxiliary teachers,
construction)
MK______________________
b. Continuous assessment
MK______________________
c. Teacher and learner
motivation
MK______________________
d. Remedial Classes
MK_____________________
(ii) To reduce drop-out
rates in primary schools
(MK___________________
a. Community
sensitization and
mobilization
MK________________
b. support to vulnerable boys
and girls including special
needs learners
MK_________________
(iii) Governance & Management
(MK___________________)
(Training of PTAs, SMCs,
Mother/father groups)
MK_______________________
Other (specify)
1: ___________________
MK_______________
2:
MK: ______________
3: _________________
MK. _______________
C. 12a Did the school receive
TLMs grant?
1 =Yes |___| .
2 = No |___|
If yes, How much?
MK_________________
What was the date received?
………/……../
C. 12b Does the school
have a budget for TLMs
grant?
1 = Yes |___| .
2 = No |___|
C. 12c If yes, how much money was spent on the following
a. Textbooks MK______________________
b. Teacher Guides MK_____________________
c. Chalk MK_____________________
d. Portable chalkboards MK___________________
e. Scheme books MK____________________
Other (specify) MK____________________
ASC Primary 2023
OFFICIAL
Balance in the Bank if any: MK ______________________________________
SECTION D: Infrastructure and Sanitation Information
D.1.a. Buildings (Rooms) by condition, and type
Type of Rooms
Existing Rooms
Number of
rooms
requiring
rehabilitat
ion
Required
Permanent
room (Exclude
those currently
under
construction)
(a) Completed and in
Use
Completed and not in
use
(b) Under
Construction
Permanent
Temporary
Permanent
Temporary
Permanent
Temporary
Classrooms
Learning Shelters
Special Needs Resource
rooms
Special Needs
Preparatory Rooms
Libraries
Store Rooms
Workshops
Head Teacher office
General Office
Staff Rooms
Recreation Hall
Kitchen
Teachers’ Houses
Feeding Shelter
Change Rooms
D.1.b. Is the School having a boarding facility?
Yes
No, If ‘No’, go to D.1.c
D.1.b.i. Primary School Boarding Facility
Number of Hostels
Completed and in Use
Completed and not
in Use
Under
Construction
Required to meet the
demand
D.1.b.ii. Boarding Materials
Description
Available
Damaged
Required
Number of Beds
Number of Mattresses
B.17. School health and nutrition
ASC Primary 2023
OFFICIAL
B.17a.1. Does the school have a school feeding programme
1. Yes 2. No
B.17.a.2. If yes, who are the implementers______________________________________
B.17.a.3. What is the Model
1. Centralized 2. Homegrown
B.17b. Does the school have an emergency management Plan?
1. Yes 2. No
D.1.c. Availability and Type of Sanitary Facilities
Number of
Flush Toilets
Number of pit
latrines/ drop holes
Number of
Disability friendly
toilets
Number of Urinal
Block
Number of hand washing facility
Improved
Basic
Improved
Bas
ic
Improved
Basic
Hand
washing
facility
with soap
and
water
Hand
washing
facility
with
water
only
No hand
washing
facility
Type of
Users
In
Use
Under
Constr
uction
In
Use
Under
Constr
uction
In
Use
In
Use
Under
Constr
uction
In
Use
In
Use
Unde
r
Cons
tructi
on
In
Use
Girls
Boys
Female
Staff
Male
Staff
D.1. C. 1 Number of Change rooms
Incinerator
Improved
Basic
Improved
Basic
In use
Under
construction
In use
Under construction
In use
Under construction
In use
Under
construction
D.2. Buildings (Permanent Rooms) under Construction (Construction Incomplete) by status and type (Count a room only once)
Type of Rooms
Working on
foundation
Foundation
completed; needs or
working on walls
Foundation and walls completed; needs or working
on roof / floor
Classrooms
Learning Shelter
Libraries
Store Rooms
Workshops
Offices
Staff Rooms
Latrine Blocks
Teachers’ Houses
Feeding Shelter
Change Rooms
Special Needs Resource room
Special Needs Preparatory Rooms
Recreation Hall
Note: The totals for each building/room type must be equal to the ones listed under construction columns (iii) &, (iv) in D.1
ASC Primary 2023
OFFICIAL
D.2.a. Number of rooms available for each standard
Description
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
Total
Permanent
Learning
Shelter
Temporary
Grand Total
D2. C 1 Number of classrooms with Ramps
Standard
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
Total
D2. d. Newly Constructed (Complete) Infrastructures in the previous year
Type of Room
Organization that Constructed
If constructed by the
school,
What is the source of
finance
Number of Rooms
Classrooms
Learning shelter
Libraries
Store Rooms
Workshops
Offices
Staff Rooms
Latrine Blocks
Teachers’ Houses
Feeding Shelter
Low Cost Classrooms
Change Rooms
Special Needs Resource room
Special Needs Preparatory Rooms
Recreation Hall
D.3. Which of the following are available at school
School Structure
Available
[1=Yes, 2=No]
in Use
[1=Yes, 2=No]
School Agricultural
Activities
Available
[1=Yes, 2=No]
in Use
[1=Yes, 2=No]
Lawns
General garden
Flower beds
Woodlot
Pavements
Experimental Plots
Playing field
Vegetable Garden
Fence – brick wall
Orchard
Fence – hedge
Fish Pond
Fence – Wire
Poultry Project
Other (Specify)
Other
ASC Primary 2023
OFFICIAL
1. _______________________
2. _______________________
1. __________________
2. __________________
D.4. Main Drinking
Water Source
D4. a. Is the water
source functional?
D.5. Electricity
Source
D.6. Does School have
1. Piped Water
2. Borehole
3. Protected hand dug
well with pump
4. Protected Spring
5. Unprotected hand
dug well
6. Unprotected Spring
7. River
8. Lake
9. Rain Water Tank
10. No Water
1. Yes
2. No
D.4.b. Distance to
water source
(In meters)
D.4.c. Number of
water points at a
school
_____________
1. ESCOM
2. Generator
3. Solar Power
4. No Electricity
Description
Head Teacher’s
office
Staff room
Number
Number
Tables
Chairs
Cupboard
Filing Cabinet
Benches
Forms
Lockable book
shelves
D.7. (a) Furniture for class rooms
Description
Type
Number Available
SNE
prepa
ratory
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
Total
damage
d
currentl
y not in
use
Requi
red
Furnit
ure
for
SNE
Required
Desks
Pupils
Teachers
Benches
Pupils
Teachers
Forms
Pupils
Teachers
Tables
Pupils
Teachers
Chairs
Pupils
Teachers
D.7. (b)Other facilities available
Facility
Number of Usable Facilities
Total number damaged (currently not
usable)
School phone
Computers
Tablets
ASC Primary 2023
OFFICIAL
Printers
Mobile Chalk boards
School Radios
Solar Lamp
Photo copiers
Assistive device SNE
First Aid Kit
Sports kit Equipment
SECTION E: Teaching and Learning Materials for the current curriculum
E.1. Number of Pupils Books in good condition
Description
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
Kuyamba Sukulu
Do not fill in these cells Do not fill in these cells Do not fill in these cells
English
Chichewa
Mathematics
Do not fill in these
Numeracy & Mathematics
Do not fill in these cells Do not fill in these cells Do not fill in these cells
Expressive arts
Bible Knowledge
Agriculture
Do not fill in these cells
Science & Technology
Do not fill in these cells
Social and Environmental
Sciences
Do not fill in these
Religious Education
Life Skills
Don’t fill
Total
E.2. Number of Teacher Guides available in good condition for the current curriculum
Description
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
Kuyamba Sukulu
Do not fill in these cells Do not fill in these cells Do not fill in these cells
English
Chichewa
Mathematics
Do not fill in these
Numeracy & Mathematics
Do not fill in these cells Do not fill in these cells Do not fill in these cells
Expressive arts
ASC Primary 2023
OFFICIAL
Bible Knowledge
Agriculture
Do not fill in these cells
Science and Technology
Do not fill in these cells
Social and Environmental
Sciences
Do not fill in these
Religious Education
Life Skills
Don’t fill
Total
E.2. Number of inclusive Teacher Guides available in good condition
Description
Large Print
Regular
Audio
Braille
Kuyamba Sukulu
English
Chichewa
Mathematics
Numeracy & Mathematics
Expressive arts
Bible Knowledge
Agriculture
Science and Technology
Social and Environmental
Sciences
Religious Education
Life Skills
Total
E.2.1 Information and Communication Technology (ICT)
a. Does the school officer ICT
Lessons
1. Yes
2. No
b. Is the School connected to
internet
1. Yes
2. No
F.1. Teaching Staff – Reason for Leaving this School (last year)
Reason for leaving
Number of Teachers
Male
Female
Total
Transferred to a non-teaching post
Resigned
Voluntary Retired
Mandatory Retired
Public demand Retired
ASC Primary 2023
OFFICIAL
Medically retired
Prolonged Illness
Dismissed
Death
Transferred to another school
Reason not known
Other (specify)
Total
F.2. Support Staff
Sex
Male
Female
Total
Cleaners
Guards
Bursar
Messenger
Grounds Men
Other (Specify)
Total
F 3. Teachers’ Details (Current year) (See list of codes below)
List of Codes for Teacher Information
c – Disability
h – Highest Academic
qualifications
i – Teacher Grade
j - Teacher
Training
m– Additional
School
Responsibilities
1=Low Vision
2=Blind
3=Hard of hearing
4=Deaf
5=Physical Impairment
6=Other (Specify)
a. …………………
b. …………………
c. …………………
d. …………………
1= Junior Certificate
2= Malawi School
Certification of
Education (MSCE)
3= Diploma in Education
4=Degree in Education
5=Non Education Diploma
6=Non Education Degree
1 = PT4 (L)
2 = PT3 (K)
3 = PT2 (J)
4 = PT1 (I)
5 = P8 (H)
6 = Auxiliary (paid by
community)
7 = Volunteer
8 = Private School
Teacher
1= MASTEP
2= MIITEP
3= 2 YEAR
4= 1 YEAR
5= Untrained
6= On training
7= IPTE(1+1)
8=ODL
1=Head Teacher
2=Deputy Head
Teacher
3=Sports Organizer
4=Section Head
5= None
6=Referee (football)
7= Umpire
8= Coaching
9= First Aid
10=Other
15
OFFICIAL
F.4. SNE Specialist Teachers’ Details (See list of codes above on page 10)
Sr
Surname
(use names
appearing on
payroll)
(a)
First Name & initials
(use names appearing
on payroll)
(b)
Disability
Type of
teacher
1=itinerant
2= Stationed
Employment
Number
EDE0
(d)
Area of
Specialization
Sex M/F
(f)
Date of
Birth
dd/mm/yyyy
(g)
Highest
Level of
education
See Code
(h)
Teacher
Grade
See
Code
(i)
Teacher
Training
See
Code
(j)
Date of 1st
Appt.
dd/mm/yyyy
(k)
Date of
Appt. to
present
grade
dd/mm/yyyy
(l)
Total
number of
visit to
schools per
term
(If itinerant
teacher)
Total
Teaching
period
per week
(n)
Standard Teaching
(o)
1
VI HI
LD DB
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
2
VI HI
LD DB
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
3
VI HI
LD DB
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
4
VI HI
LD DB
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
5
VI HI
LD DB
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
6
VI HI
LD DB
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
7
VI HI
LD DB
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
8
VI HI
LD DB
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
9
VI HI
LD DB
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
10
VI HI
LD DB
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
16
OFFICIAL
F.5. Teachers’ Details (See list of codes above on page 10)
Surname
(use names
appearing on
payroll)
(a)
First Name &
initials
(use names
appearing on
payroll)
(b)
Disability
See Code
(c)
Employment
Number
EDE0
(d)
Registration
Number
(e)
National
Identification
Number
Sex
M/F
(f)
Date of
Birth
dd/mm/yyyy
(g)
Highest
Academic
qualification
See Code
(h)
Teacher Grade
See Code
(i)
Teacher
Training
See
Code
(j)
Date of 1st
Appt.
dd/mm/yyyy
(k)
Date of
Appt. to
present
grade
dd/mm/yyyy
(l)
Date
Posted
to this
school
Additional
School
Responsibility
See Code
(m)
Main
Class
Allocated
Total
Teaching
period
per week
(n)
Standard Teaching
(o)
1
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
2
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
3
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
4
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
5
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
6
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
7
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
8
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
9
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
10
T__/______/___
___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
17
OFFICIAL
Surname
(use names
appearing on
payroll)
(a)
First Name &
initials
(use names
appearing on
payroll)
(b)
Disability
See Code
(c)
Employment
Number
EDE0
(d)
Registration
Number
(e)
National
Identification
Number
Sex
M/F
(f)
Date of
Birth
dd/mm/yyyy
(g)
Highest
Academic
qualification
See Code
(h)
Teacher Grade
See Code
(i)
Teacher
Training
See
Code
(j)
Date of 1st
Appt.
dd/mm/yyyy
(k)
Date of
Appt. to
present
grade
dd/mm/yyyy
(l)
Date
Posted
to this
school
Additional
School
Responsibility
See Code
(m)
Classes
Allocated
Total
Teaching
period
per week
(n)
Standard Teaching
(o)
11
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
12
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
13
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
14
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
15
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
16
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
17
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
18
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
19
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
20
T__/______/___
___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
18
OFFICIAL
F.5. Teachers’ Details (See list of codes above on page 10)
19
OFFICIAL
Surname
(use names
appearing on
payroll)
(a)
First Name &
initials
(use names
appearing on
payroll)
(b)
Disability
See Code
(c)
Employment
Number
EDE0
(d)
Registration
Number
(e)
National
Identification
Number
Sex
M/F
(f)
Date of
Birth
dd/mm/yyyy
(g)
Highest
Academic
qualification
See Code
(h)
Teacher Grade
See Code
(i)
Teacher
Training
See
Code
(j)
Date of 1st
Appt.
dd/mm/yyyy
(k)
Date of
Appt. to
present
grade
dd/mm/yyyy
(l)
Date
Posted
to this
school
Additional
School
Responsibility
See Code
(m)
Classes
Allocated
Total
Teaching
period
per week
(n)
Standard Teaching
(o)
21
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
22
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
23
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
24
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
25
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
26
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
27
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
28
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
29
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
30
T__/______/___
___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
Surname
(use names
appearing on
payroll)
(a)
First Name &
initials
(use names
appearing on
payroll)
(b)
Disability
See Code
(c)
Employment
Number
EDE0
(d)
Registration
Number
(e)
National
Identification
Number
Sex
M/F
(f)
Date of
Birth
dd/mm/yyyy
(g)
Highest
Academic
qualification
See Code
(h)
Teacher Grade
See Code
(i)
Teacher
Training
See
Code
(j)
Date of 1st
Appt.
dd/mm/yyyy
(k)
Date of
Appt. to
present
grade
dd/mm/yyyy
(l)
Date
Posted
to this
school
Additional
School
Responsibility
See Code
(m)
Classes
Allocated
Total
Teaching
period
per week
(n)
Standard Teaching
(o)
31
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
32
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
33
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
34
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
35
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
36
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
37
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
38
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
39
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
40
T__/______/___
___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std4
Std5
Std6
Std7
Std8
20
OFFICIAL
Thank you for your time and cooperation and REMEMBER:
1. Review that all the information has been accurately and clearly completed. Verify all totals.
2. Complete the QUESTIONNAIRE TRACKING/CERTIFICATION INFORMATION and the PRELIMINARY COUNTS for pupils and teachers information on the first page.
3. Retain 1 copy for the school and submit 2 copies to yourPEA/Coordinator/DEM/MOE.
Surname
(use names
appearing on
payroll)
(a)
First Name &
initials
(use names
appearing on
payroll)
(b)
Disability
See Code
(c)
Employment
Number
EDE0
(d)
Registration
Number
(e)
National
Identification
Number
Sex
M/F
(f)
Date of
Birth
dd/mm/yyyy
(g)
Highest
Academic
qualification
See Code
(h)
Teacher Grade
See Code
(i)
Teacher
Training
See
Code
(j)
Date of 1st
Appt.
dd/mm/yyyy
(k)
Date of
Appt. to
present
grade
dd/mm/yyyy
(l)
Date
Posted
to this
school
Additional
School
Responsibility
See Code
(m)
Main
Class (es)
Allocated
Total
Teaching
period
per week
(n)
Standard Teaching
(o)
41
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std
4
Std5
Std6
Std7
Std
8
42
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std
4
Std5
Std6
Std7
Std
8
43
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std
4
Std5
Std6
Std7
Std
8
44
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std
4
Std5
Std6
Std7
Std
8
45
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std
4
Std5
Std6
Std7
Std
8
46
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std
4
Std5
Std6
Std7
Std
8
47
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std
4
Std5
Std6
Std7
Std
8
48
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std
4
Std5
Std6
Std7
Std
8
49
T__/______/___
__/__/___
__/___/____
__/___/___
Std1
Std2
Std3
Std
4
Std5
Std6
Std7
Std
8
